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在中国中年女性中识别更年期症状的不同亚型:潜在类别分析。

Identifying the different subtypes in menopausal symptoms among middle-aged women in China: a latent class analysis.

机构信息

Department of Health Psychology, School of Nursing and Rehabilitation, Cheeloo College of Medicine, Shandong University, Jinan, Shandong, China.

出版信息

Menopause. 2021 Sep 20;28(12):1418-1427. doi: 10.1097/GME.0000000000001864.

Abstract

OBJECTIVE

Many studies have focused on the severity and prevalence of menopausal symptoms among middle-aged women, which are limited by heterogeneity and diversity of subtypes. Subtyping facilitates the adaptation to prevention and clinical intervention strategies that target women. To determine the existence of significant subgroups of women with similar menopausal symptoms, a person-centered approach was used to identify potential profiles of women during the menopausal transition. In addition, we aimed to examine the association between latent subtypes and individual factors.

METHODS

This cross-sectional study included 797 middle-aged women, aged 40 to 60 years, who were recruited from Shandong Province, China, between December 2017 and August 2018. We identified the subtypes in menopausal symptoms by performing a latent class analysis according to the self-reported Menopause Rating Scale and evaluated the robustness of our identified subtypes using a sensitivity analysis. Multinomial logistic regression was performed to explore the association between emergent latent subtypes and sociodemographic, clinical, and psychosocial characteristics.

RESULTS

The mean age of participants was 49.83 ± 5.05 years. (1) Four potential classes were identified in middle-aged women: "severe symptoms" (14.9%), "dominant sleep-emotion symptoms" (31.4%), "physical/mental exhaustion symptoms" (32.5%), and "no symptoms" (21.2%). The four classes were also verified using a sensitivity analysis according to age and menopause status subgroups, which revealed the robust subtypes of menopausal symptoms. (2) The odds ratio of neuroticism, chronic diseases, and gynecological diseases were significantly higher for the "severe symptoms," "dominant sleep-emotion symptoms," and "physical/mental exhaustion symptoms" classes, compared to the "no symptoms" class, while the odds ratio of mindfulness and social support were lower.

CONCLUSIONS

A person-centered approach for middle-aged women could address the unmet need to understand the heterogeneity of menopausal symptoms. Subtyping facilitates the identification of the potential causes of menopausal symptoms and the development of personalized interventions.

摘要

目的

许多研究都集中在中年女性的更年期症状的严重程度和流行程度上,但这些研究受到了亚类别的异质性和多样性的限制。对亚类别的细分有助于适应针对女性的预防和临床干预策略。为了确定具有相似更年期症状的女性存在显著亚组,采用以人为中心的方法来确定更年期过渡期间女性潜在的特征。此外,我们旨在研究潜在亚类与个体因素之间的关系。

方法

这项横断面研究纳入了 2017 年 12 月至 2018 年 8 月期间从中国山东省招募的 797 名年龄在 40 至 60 岁的中年女性。我们根据自我报告的更年期评定量表进行潜在类别分析,以确定更年期症状的亚类,并使用敏感性分析评估我们确定的亚类的稳健性。采用多项逻辑回归分析来探讨新兴的潜在亚类与社会人口学、临床和心理社会特征之间的关系。

结果

参与者的平均年龄为 49.83±5.05 岁。(1)在中年女性中确定了四个潜在的类别:“严重症状”(14.9%)、“主导睡眠情绪症状”(31.4%)、“身体/精神疲惫症状”(32.5%)和“无症状”(21.2%)。根据年龄和更年期状态亚组进行的敏感性分析也验证了这四个类别,结果显示更年期症状的亚类具有稳健性。(2)与“无症状”组相比,“严重症状”、“主导睡眠情绪症状”和“身体/精神疲惫症状”组的神经质、慢性疾病和妇科疾病的优势比显著更高,而正念和社会支持的优势比更低。

结论

针对中年女性的以人为中心的方法可以满足理解更年期症状异质性的未满足需求。对亚类别的细分有助于确定更年期症状的潜在原因,并制定个性化的干预措施。

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